In the aftermath of the workshop decision regarding aggressive resuscitation of 23 0/7 week infants, I cannot think of a more appropriate retrospectoscope than one that reviews the case of the Miller baby. (PVG)

There were no rejected manuscript(s) and zero rejected letter(s) for this volume (we will NOT publish specific information about individual rejections).

We received and honored a request for the withdrawal of the manuscript entitled: “Influence of Maternal Factors on Birth Weights of Neonates” by Anshumali Jyothishi, Rajesh K. Padhi and Soumya Mishra in Volume 3, Issue 3, Summer 2013. Because eJNR is an entirely electronic journal, the article was removed and all links severed. This missive will now serve as the only record of the original publication. The reason given for the withdrawal was a recent, post-publication finding of critical errors in the data collection and statistics, making the study invalid.

Nobody thinks in utero drug exposure is a good thing, but living through the unfortunate “crack baby” labeling experience leads me to believe we should be optimistic about human potential to overcome developmental exposures during this current rise of narcotic (and other drug) exposed babies. PVG

Neonatology Journal Club:

Two forms of “NEC-like disease” that do not fit with normal models of NEC presentation:

This quarter’s journal club is designed to illustrate that there are aberrant subsets of NEC-like disease that do not behave like the majority of NEC when it comes to the timing of presentation or the normal prerequisites of feeding. Understanding that there are specific agents and events that can modify the timing and presentation of NEC is a crucial weapon for the neonatal clinician to have in their NEC prevention arsenal. You never know when the next unrecognized NEC-like disease cluster might show up (and we w0uld be happy to take y0ur sentinel report of it in eJNR if you discover it).

The timing of NEC is consistent with Sartwells model of disease incubation:

Take home message: IVIG associated disease occurs even earlier than term NEC and with minimal feeds. It occurs most commonly in ABO blood types (versus rH) and they are the only ones thus far who have required surgery or have died. Etiology may be via blood group antibodies in the IVIG attacking enterocytes that express the antigen (editor’s hypothesis).

Take home message: Timing is way after the window predicted by Sartwell’s model of disease incubation. Most likely explanation for this disease is fermentation of natural gum secondary to non-sterile product, resulting in short chain fatty acids that are injurious to the colon, eventually leading to late onset colonic NEC-like disease.

EDITORS’ EXTRAS

Retrospectoscope: since we have two manuscripts involving off lable iNO therapy, we thought it would be good to link to this document as refresher on when to use iNO.

Editors note: we are disappointed that the committee did not also discuss the importance of uniform caregiver sick leave policy and the potential for NICU caregivers to transmit viral agents when they come to work medicated for viral symptoms rather than taking sick leave. We believe this an important and largely ignored variable for health care-associated infections.

Neonatology Journal Club:

Gastroschisis - Assessing the Trends in Neurodevelopment and Quality of Life Over Time (with a short lesson about access obstructionism)

* Please note this journal club is also an exercise in testing manuscript availability, cost and timeliness at your institution. This is a limited scenario. An author might face many times this magnitude of difficulty when trying to write a manuscript on such a topic. Please imagine the frustration and cost associated with obtaining topic specific PDFs for nearly every manuscript or grant that a graduate student or career scientist must write in the course of pursuing their research. The open access movement would erase this frustration, whereas the Research Works act would entrench it, potentially forever. Moreover, it is a specific form of government-sanctioned obstructionism, just for American funded science. How can we compete globally in such an envirnoment? We urge you to write your congressmen and senators and sign the white house petition over this issue without delay (we’ve made it easy, just click to find their email address).